4.6 Article

Feasibility of a CT-based lymph node radiomics nomogram in detecting lymph node metastasis in PDAC patients

Journal

FRONTIERS IN ONCOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2022.992906

Keywords

pancreatic ductal adenocarcinoma; lymph node metastasis; radiomics; nomogram; computed tomography

Categories

Funding

  1. medical research Key Program of the combination of Chongqing National health commission and Chongqing science and technology bureau, China [2019ZDXM010]
  2. medical research Program of the combination of Chongqing National health commission and Chongqing science and technology bureau, China [2020FYYX151]

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The study investigates the potential value of a contrast enhanced computed tomography (CECT)-based radiological-radiomics nomogram in predicting lymph node metastasis in patients with pancreatic ductal adenocarcinoma (PDAC). The nomogram combines a lymph node radiomics signature and lymph nodes' radiological features. The results show that the radiological-radiomics nomogram outperforms the radiomics score and radiological models individually, providing a valid and convenient tool for personalized risk assessment and clinical decision-making.
ObjectivesTo investigate the potential value of a contrast enhanced computed tomography (CECT)-based radiological-radiomics nomogram combining a lymph node (LN) radiomics signature and LNs' radiological features for preoperative detection of LN metastasis in patients with pancreatic ductal adenocarcinoma (PDAC). Materials and methodsIn this retrospective study, 196 LNs in 61 PDAC patients were enrolled and divided into the training (137 LNs) and validation (59 LNs) cohorts. Radiomic features were extracted from portal venous phase images of LNs. The least absolute shrinkage and selection operator (LASSO) regression algorithm with 10-fold cross-validation was used to select optimal features to determine the radiomics score (Rad-score). The radiological-radiomics nomogram was developed by using significant predictors of LN metastasis by multivariate logistic regression (LR) analysis in the training cohort and validated in the validation cohort independently. Its diagnostic performance was assessed by receiver operating characteristic curve (ROC), decision curve (DCA) and calibration curve analyses. ResultsThe radiological model, including LN size, and margin and enhancement pattern (three significant predictors), exhibited areas under the curves (AUCs) of 0.831 and 0.756 in the training and validation cohorts, respectively. Nine radiomic features were used to construct a radiomics model, which showed AUCs of 0.879 and 0.804 in the training and validation cohorts, respectively. The radiological-radiomics nomogram, which incorporated the LN Rad-score and the three LNs' radiological features, performed better than the Rad-score and radiological models individually, with AUCs of 0.937 and 0.851 in the training and validation cohorts, respectively. Calibration curve analysis and DCA revealed that the radiological-radiomics nomogram showed satisfactory consistency and the highest net benefit for preoperative diagnosis of LN metastasis. ConclusionsThe CT-based LN radiological-radiomics nomogram may serve as a valid and convenient computer-aided tool for personalized risk assessment of LN metastasis and help clinicians make appropriate clinical decisions for PADC patients.

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